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Electronic health record giant Epic Systems is working with medical care providers and two of the nation's largest health insurers to speed prior authorization reviews.
A KFF report indicates that health insurers denied at least 1 in 8 standard prior authorization requests across Medicare Advantage, Medicaid, and Obamacare last year.
Health insurers are discontinuing Medicare Advantage plans, potentially leaving many older adults, especially in rural areas, to seek new health coverage next year.
New investigations by NDR, WDR, and Süddeutscher Zeitung have uncovered additional millions in losses for German health insurance funds and associations. These losses stem from questionable investments that were reportedly approved by economic law firms.
French Health Minister Stéphanie Rist announced new draft decrees to transfer more healthcare reimbursement costs from state health insurance to private complementary health insurers (mutuelles), particularly for dental consultations, medical transport, and less effective medications.
Mark Cuban suggests that artificial intelligence has the potential to reveal instances where health insurers are overcharging employers, helping them identify and address financial discrepancies.
A new report indicates that prohibiting certain contracts between hospital systems and health insurers could lead to an estimated $45 billion in savings for Americans.
Three hospitals in Dublin are reportedly owed more than €12 million by private health insurance companies, with a Dáil spending watchdog criticizing the 'nonchalant attitude' towards recovering these funds.
Smaller health insurance companies in the Czech Republic are set to receive approximately 7.9 billion Czech crowns from the General Health Insurance Company (VZP) this year, following a new amendment signed by President Pavel.
Major health insurers are showing signs of recovery, but a crucial test looms as they have incomplete data on medical costs for the first quarter due to a lag in claims processing.
Health insurers are raising questions about a new Medicare program that will offer GLP-1 medications to seniors for $50 per month, leading to a drop in shares for pharmaceutical companies like Novo Nordisk and Eli Lilly amid concerns over coverage plans.
A report indicates that health insurers collectively made $13 billion in profits as a result of a specific policy decision made in Washington.
The Trump administration has finalized a 2.48% increase in average Medicare Advantage payments, totaling over $13 billion, which is seen as a boost for health insurers.
Both patients and doctors are expressing frustration with health insurance companies, citing system complexity and the insurers' ability to profit from it as major issues.
The head of the Czech health insurance association warns that some health insurance companies may face overdue liabilities by year-end, as parliament considers a proposal to redistribute nearly eight billion Czech crowns from the General Health Insurance Company to smaller insurers.
More than 30 states have passed laws trying to rein in health insurance companies second guessing doctors, a policy called prior authorization.
Cigna names company veteran Brian Evanko as CEO to succeed David Cordani, who has been in charge for 27 years.
Health insurers are reportedly withdrawing Medicare Advantage plans, a move that is expected to impact nearly 3 million older Americans.
A commentary argues that hundreds of millions of Swiss francs are illegally flowing into doctors' pockets through an opaque rebate system instead of benefiting premium payers, calling for health insurers to take responsibility.
Health insurers are reportedly dropping Medicare Advantage plans, which could affect a significant number of seniors.
Official data indicates a slight decrease in top salaries and administrative costs for health insurers in Switzerland, though rising healthcare costs remain the primary concern.
Health insurers in the Netherlands are launching 14 new "maternity hotels" across the country. This initiative aims to tackle disparities in maternity care, which have arisen due to a shortage of healthcare professionals.
An article discusses the appropriate roles of health insurers, doctors, and AI in determining patient treatment plans, advocating for clinicians and AI-driven tools to make better decisions based on full health history.
German health insurance funds are calling for even tougher austerity measures to curb continuously rising medical care costs, pushing for more cuts beyond the coalition's controversial savings package.
The Trump administration has initiated a new effort to combat fraud, ordering insurance companies to investigate fraudulent activities within federal employee health programs, which cost taxpayers approximately $70 billion annually.
Analysts suggest that a reduction in medical costs is currently favorable for health insurers, though they anticipate significant challenges ahead for the industry.
Health insurers in the United States are advancing new measures aimed at standardizing prior authorization requirements. This initiative seeks to streamline the process for medical treatments and services.
Swiss health insurance companies are reportedly overpaying by 40 million francs for medication, failing to systematically claim discounts negotiated by the federal government, at the expense of policyholders.
The U.S. government has finalized a 2.48% increase in Medicare Advantage payments to insurers for 2027. This decision, which was previously anticipated, has already led to a surge in insurance company stock prices and significantly impacts the healthcare sector.
The Turkish competition watchdog has initiated an investigation into 19 companies operating in the country's health insurance market, probing allegations of premium fixing.
Health insurance policies are undergoing significant changes, with price increases and reduced benefits leading to warnings for consumers about potentially thousands of euros in extra costs for procedures like hip replacements.
Patients often wait months for a therapy place. The situation could now worsen. Health insurers are cutting fees - and justify this with recently increased reimbursements. By J.
The big for-profit health insurers who run the Medicare Advantage program aren’t happy with the latest government watchdog report
A debate is ongoing in Germany regarding potential cuts to health insurance services, such as dental cleanings, due to an overloaded healthcare system, with health insurers and doctors expressing differing views.
Americans' dissatisfaction with medical coverage, driven by higher premiums and rising medical bills, has intensified following the killing of UnitedHealth executive Brian Thompson.
A report by financial control reveals that doctors, hospitals, and pharmacists in Switzerland are collecting 360 million Swiss francs in drug discounts from pharmaceutical companies, which should rightfully belong to patients or health insurers. This practice is still widely considered a minor offense within the industry.
Standalone health insurers are reportedly gaining market share in India, while general insurers are losing ground in the competitive insurance sector.
Slovakia is expecting a heatwave with temperatures reaching 40 degrees Celsius, while a separate report highlights issues between health insurance companies Dôvera and Union and local authorities.
At least 17 German health insurance funds and associations have lost a minimum of 170 million euros by investing contribution funds in dubious real estate funds.
Legislators across the U.S. are attempting to reduce prescription drug costs by regulating the large companies, known as Pharmacy Benefit Managers (PBMs), that handle drug coverage for health insurers.
The head of Swiss health insurance associations criticizes the prescription practices for weight-loss injections, which are costing health insurers 200 million Swiss francs, while doctors defend their use and warn against stigmatizing obese individuals.
Despite being listed by health insurers, coverage for weight loss drugs is not necessarily guaranteed, leading to potential confusion and out-of-pocket costs for patients.
Analysts suggest that easing medical costs are a positive development for health insurers, though they note that the real test for the sector lies ahead.
U.S. health insurers are reportedly stepping up reforms to their prior authorization processes, aiming to streamline healthcare approvals.
Doctors, hospitals, and health insurers in Switzerland are protesting against overwhelming administrative burdens, such as double documentation and incompatible systems, by using "paper tiger" stickers in a campaign led by the largest medical professional society.
Health insurance companies saw their stock prices increase after the US government announced a decision to raise Medicare Advantage payment rates for 2027.
In Germany, a decision has been made to reimburse four medications for Long Covid and Post-Covid by health insurance companies, despite them being approved for other indications, as there are currently no approved drugs specifically for these conditions.
A trial has begun against the former directors of the Corela private clinic in Switzerland, accused by prosecutors of declaring sick patients as fit for work to satisfy health insurers.
German statutory health insurance funds anticipate a multi-billion euro deficit by 2027, prompting the federal government to plan fundamental reforms, with the free co-insurance of spouses now reportedly under consideration.
The bad incentives that lead health insurers not to balk overmuch at outrageous hospital charges.
Private health insurers in Australia have announced an average premium increase of 4.41%, though some insurers will raise their rates even higher, prompting advice on how to save money.